Summer Camp Detailed Registration Form 2017

Are you organizing a summer camp? Your customers can use this summer camp registration form template for registration. By using this camp form template you can collect camper information such as name, birth date, gender, address and parent information such as name, email, number and emergency information such as contact's name, phone number, relationship. Also, your customers can explain health or behavioral conditions, drug allergies, activity restrictions and they can select a fee by using this registration form format for summer camp.

Participations, Release, and Medical Agreement

While we make every effort to provide a safe and pleasant environment for every camper who attends Camp Grace, we do require that this participation agreement be read, filled out, signed, and dated by all campers (or their parent/guardian if under the age of 18) who wish to participate in activities at Camp Grace.

With full knowledge, I accept full responsibility for any injury or accident that may occur to myself, my spouse, or my child while participating in Camp Grace activities. I give permission for my child to participate in activities that occur at Camp Grace. These activities may include, but are not limited to, high ropes course, archery, riflery, paintball, rock-climbing, activities at the Laramie River, slingshots, hiking, campfire activities, and strenuous competition games.

Although Camp Grace has taken reasonable steps to provide equipment and skilled employees so yourself, your spouse, or your child can participate in activities for which he/she may not be skilled in, we do remind you that these activities are not without risk. Certain risks cannot be eliminated due to our camp's rural setting and without destroying the unique character of those activities. The same elements that contribute to the character of these activities can be cause of loss or damage to your property, accidental injury or illness or, in exteme cases, permanent trauma or death. We do not want to frighten you or reduce your enthusiasm for these activities, but we do think it is important for you to be informed and know in advance about inherent risks.

For promotional or marketing purposes, Camp Grace reserves the right to use any audio, video, and/or photography of guests or campers participating at Camp Grace facilities.

I, on behalf of myself, my children, my assigns and my estate, agree to release and hold harmless Camp Grace, its officers, board, agents or employees, for any and all claims for injuries, causes of action, or liability related to my child's participation in any activity occurring at Camp Grace. This release does not apply to intentional and/or willful acts of misconduct by Camp Grace or any of its officers, board, agents or employees.

Should Camp Grace, or anyone acting on their behalf, be required to incur attorney's fees and costs to enforce this agreement, I agree to indemnify and hold Camp Grace harmless for all such fees and cost.

By signing this document, I acknowledge that if anyone is hurt or property damaged during my or my child's participation in these activities, I and/or my child may be found by court of law to have waived any right to maintain a lawsuit against Camp Grace on the basis of any claim which has been released herein. I have had sufficient opportunity to read this entire document. I have read and understood it, and agree to be bound to its terms.

Health or Behavioral Conditions:

Drug Allergies or Other Allergic Reactions:

Dietary Needs/Restrictions:

Medication Taken Regularly:

Activity Restrictions:

I give permission for myself or my child to attend camp at Camp Grace. I understand that my personal insurance will provide primary coverage for medical aid and that Camp Grace will provide excess coverage. I also understand that if myself or my child must be sent home because of disciplinary or other problems, I will assume the additional transportation cost. IN CASE OF MEDICAL EMERGENCY, I hereby give permission to the physician selected by the camp director or his agent to hospitalize, secure proper treament for, and order injection, x-ray, anesthesia, or surgery for myself or my child as named previously.

Myself or my child is immunized against the following according to H.E.W standards: Polio, Measles, Mumps, Rubella, Diphtheria, Tetanus, and Whooping Cough. (Please notify the camp if this child has been exposed to any communicable disease during the two weeks prior to camp attendance.)

My child is not immunized.

Insurance Company:

Policy Number:

Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

Signature

Clear

Payment: You may choose to pay below with Paypal or you can mail in a check with at least your registration fee. You may choose to pay the full camp fee ($219) or just pay the registration fee now and finish paying later.